Emily Koen, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

125902 Issued in MA

Practice address

130 Jeds LN
Mason, NH 03048-4602

Phone

(603) 803-6910

Fax

(603) 664-4562

NPI assigned

Jul 7, 2022

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grit Therapeutic Services PLLC

  • Clinical Social Worker
  • Mason, NH
  • NPI 1467235747

  Clinical

  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

• Emily Marsh Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2023.

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1508599549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 EASTBROOK RD STE 303",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020262084",
            "telephone_number": "617-763-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 JEDS LN",
            "city": "MASON",
            "state": "NH",
            "postal_code": "030484602",
            "telephone_number": "603-803-6910",
            "fax_number": "603-664-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEN",
        "first_name": "EMILY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "125902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 2",
            "identifier": "1184171019",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.grittherapeuticservices.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "130 Jeds Ln",
            "city": "Mason",
            "state": "NH",
            "country_code": "US",
            "postal_code": "030484602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "MARSH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grit Therapeutic Services PLLC
• Matthew J Lane, LPN/LVN
• Linda N Lannin, OTL
• Jennifer Messer, RDN
• Sau 89
• Michelle Ives Scott, RD

• All providers in Mason, NH
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.